Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Keith John Tanenbaum, LCSW

Individual provider Mental Health Counselor · NPI 1477169605

Mr. Keith John Tanenbaum, LCSW is a Clinical Social Worker in South Lake Tahoe, California. Qualified in 2017, 9 years ago. Practices with Barton Medical Foundation, a 96-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
9
Licensed in
CA
In the registry since
2020
Specialties on file
3
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

924 Emerald Bay Rd First Fl
South Lake Tahoe, CA 96150
Phone: (530) 782-9889
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1067 4th St, South Lake Tahoe, CA 96150-3459 — (530) 600-1960
  • 1362 Us Highway 395 N Ste 102-27, Gardnerville, NV 89410-7306 — (530) 782-9889

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 107974 (CA)
Mental Health Counselor Taxonomy 101YM0800X · Licence 89589 (CA)
Hospice and Palliative Medicine (Psychiatry & Neurology) Physician Taxonomy 2084H0002X · Licence 107074 (CA)

Record details

NPI number1477169605
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedSeptember 22, 2020
Last updated in NPPESOctober 5, 2022
Certification dateOctober 5, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Barton Medical Foundation — 96 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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